Daawada "Kortef": tilmaamaha loo isticmaalo, tilmaamo, sababo, qiyaasta, dib u eegista

Glucocorticosteroids (GCS) waxaa loo yaqaan daroogada dardaro, kuwaas oo analogues hormoonnada qoomiyadda soo saaray kiliyaha adrenal. GCS ayaa jidhka bini'aadamka noocyo kala duwan oo saamayn: anti-bararka iyo desensitizing, jirka, anti-sun iyo antishock.

Maanta suuqa dawooyinka of Russia waa liiska balaadhan oo ah dawooyinka sida. Mid ka mid ah iyaga ka mid ah waa "Kortef". Tilmaamaha loogu isticmaalo talinaysaa u qaadan la tiro ka mid ah cudurada.

Qaab dhismeedka iyo Curiska

medicament waxaa loogu tala galay maamulka afka. The qayb firfircoon ugu weyn "Kortef" diyaarinta (tilmaamaha ku qoran macluumaad this) waa hydrokortisoni - hormone uu soo saaray qanjidhada adrenal. Waayo, isticmaalka systemic iyo kuwa maxalliga ah waxaa loo isticmaalaa in jawi caafimaad hydrokortisoni dabiici ah ama esters ay.

In Daawooyinka "Kortef" hormone this ku jira cadadka 10 mg. Sida walxaha taag dheeraad ah sida ku milmahayn calcium, galleyda, sucrose, lactose, macdan saliid, iyo sorbic acid.

Foomka waxaa ugu weyn, taas oo la soo jeediyay ku Kortef macaamiisha "- kiniiniyada. Tilmaamaha loogu isticmaalo, bixiyeyaasha daryeel caafimaad oo dhab ah iyo bukaanka odhan oolnimada sare ee daroogada. Loox oo qaab wareeg ah iyadoo line a dushiisa iyo gadaaman waxaa ku tilmaamay «CORTEF10» baakadeeyey galay fijaan oo dhalooyinka madoobaan (kasta ka buuxeen 100 oo gogo '). Soo iibso daawooyinka oo kaliya on warqad dhakhtar ee.

pharmacodynamics

Sida hore loo sheegay, daroogada uu leeyahay liis dheer oo saamaynta on jidhka bini'aadamka, anti-bararka iyo antishock, desensitizing iyo anti-xasaasiyad, anti-sun ah, jirka iyo antimetabolite. Description of daroogada (diiwaanka) waxaa ku qoran warar ku saabsan mass ee geedi socodka ay ku daroogada saamayn ku. Waxa uu hakiyo sii daayo dhexdhexaadiyayaal bararka iyo si weyn loogu talla galay in la sii daayo cytokines (interferon, interleukins) ka macrophages iyo limfosaytis.

Sidoo kale, "Kortef" wuxuu kobciyaa kaydinta glycogen beerka, waxay kordhisaa xaddiga glucose ku jira dhiigga, dheecaanka caanuhu oo raaca Na + iyo K + kordhay. Iyada oo ku lug toos ah medicament hoos u-soo-saarka ee histamine (dhexdhexaadiye, t. E. dhexaadiyaha looga baahan yahay nooca degdeg ah cadaanyo).

Intaas waxaa sii dheer, diyaarinta Kortef "tilmaamaha loo isticmaalo sida ayaa sheegay in hab yaraynaysaa tirada dhexgalay gacanta (cell xubno la dhiigga iyo dheecaanka) iyo in ay hawshu u badneyd bararka socon karto iyo Axdigu ee leukocytes iyo limfosaytis ka caawisaa si loo yareeyo permeability gaddoonka ah. Daawada hakiyo ereygu wuxuu kordhiyaa heerka burburka protein.

"Kortef" saamayn ku pituitary iyo cabudhibayo soo saarka ee corticotropin (ACTH), iyada oo aan taas oo si buuxda u joojin kartaa howlgalka of kiliyaha adrenal.

Daawo "Kortef": waxbarida, codsiga

khubaro Guest ay sheegayaan in ay na hor daawada loo isticmaalo ee beeraha kala duwan ee daawada. Waxa loo isticmaalaa si loo soo saaro bukaanka ka sun ah, argagaxa leh, gubasho, cardiogenic, shock shaqeeya kiisaska therapy ah antishock Heerka keenay natiijo lahayn. Ha ka fikiro si aynu dhibcood, kuwaas oo si faahfaahsan.

qaybaha Sidaas, sida bukaanada qoray "Kortef"?

Tilmaamaha loogu isticmaalo, daawo description la soo geliyo macaamiisha macluumaadka ku saabsan suurtagalnimada of adeegsigeeda endocrinology. Halkan, daroogada noqon lahayd waxtar u leh cudurada sida la'aan ah, ee adrenal shaqaynaya kiliyaha Graves (subacute foomka), kelyaha (dabeecadda dhalin), hypercalcemia, kaas oo u muuqday on asalka carcinogenic.

Dheeraad ah, in Rheumatology "Kortef" si togan u muuqato in daaweyn jiray bursitis, arthritis (turqo, rheumatoid psoriatic), spondylitis ankylosing, tenosynovitis nonspecific. natiijo wanaagsan waxaa lagu gaaraa, bukaanka qaadanaya "Kortef" in erythematosus oo nidaamsan lupus, cudurka wadnaha rheumatic ba'an, polymyositis, epicondylitis.

Waxaa jira calaamado muujinaya in loo isticmaalo "Kortefa" oo duurka ku ah maqaarka. Halkan daroogada waa wax ku ool ah ee daaweynta ee pemphigus, fungoides mycosis, herpetiformis, iyo dermatitis exfoliative. Sidoo kale, waxaa lagu qoray ee cudurka psoriasis ee daran, dermatitis seborrheic, multiforme erythema socodka culus.

Allergists qori "Kortef" la jirrada serum, asal rhinitt xasaasiyad, la atypical oo xiriir dermatitis, neefta bronki iyo diidmo shakhsi daroogada.

Khubarada-Dhakhaatiirta Indhaha sida dhaqanka lagu magacaabayo "Kortefa" la tiro ka mid ah cudurada. medicament waa wax ku ool ah in boogaha corneal iyo conjunctivitis asal ahaan xasaasiyad, la keratitis iyo iritis, iridocyclitis marka, neuritis, uevite, iwm In berrinkii kansarka GCS "Kortef" qoray in leukemia, in neurolojiga - .. Multiple.

Halkee kale oo loo isticmaalo "Kortef"? Tilmaamaha loogu isticmaalo ku qoran warbixin in xil laga yaabaa in ay bukaanada pulmonology (sarcoidosis astaamaha, qaaxada sambabada fulminant, pneumonia rajo gelin) iyo Dhiigga (Torombositobiiniya sare, anemia aplastic ama hemolytic, erythroblastopenia).

Codsiyada iyo kacmaha

medicament The "Kortef" waxaa loogu talagalay maamulka afka. Si kastaba ha ahaatee, soo saarka lyophilizate ee xalka "Solu-Kortef" diiwaanka waanin intramuscularly maamula, intravenously (bolusdose ama faleebo) iyo bac periarticular.

Sida maamulka afka, qiyaasta hore laga bilaabo 20 ilaa 240 mg maalintii kala duwanaan karaan ku xiran tahay cudurka laga helay iyo darnaanta xaaladda bukaanka. qiyaas fiican in kiis kasta oo la doorto ay hoos hore qaatay in ka yar in ay bixiyaan doonaa saamaynta ay ku doonay.

In xaaladaha degdegga ah iyo baahida loo qabo in daawayn degdeg ah lagu talinayaa in maamulka dawada xididka "Solu-Kortef". Tilmaamaha loogu isticmaalo qeexayaa nidaamka soo socda caadiga ah. Xalka ugu horeysay ee 100 mg (dose hore) ay maamusho in ka badan kala bar hal daqiiqo. mugga labaad ee daroogada ee 500 mg waa in la maamulo 10 daqiiqo gudahood. Dheeraad ah, 2-6 saacadood kasta saacadood kasta, nidaamka waa in lagu celiyo, oo aan halmaamay in si joogto ah loola socdo xaaladda bukaanka.

Waa in aan xasuusnaano in qaadasho sare, "Sol-Kortef" codsatay kaliya in muddada xasilinta bukaanka, laakiin ugu badnaan 3 maalmood.

V / m "Kortef" maamula in mugga a of 125-250 mg / maalintiiba. Saamaynta daroogada wanaagsan muujiyey 6-25 saacadood ka dib hawl ka dib markii uu socon karaa dhowr maalmood ilaa dhowr toddobaad.

Haddii loo baahdo, irbado "Kortef" ahaayeen intra-articular ama periarticular bacda. qiyaasta wax ku ool ah waayo-goysyada weyn (garabka, jilibka, hip) waa 25-50 mg, laakiin xaaladaha degdegga ah iyo haddii ay gaari karaan 100 mg. Waayo, goysyada yar (suxullada, cumaacumaha, phalanges) waa mugga cirbad ku filan 10-20 mg, ka dhigay 1 mar. Ku celceli habka lagu taliyey 1-3 toddobaad kasta (oo mararka qaarkood loo baahan yahay oo marar badan - 3-5 maalmood oo kasta).

Guud ahaan, oo la xiriira daaweynta daawada "Kortef" Qiyaasta iyo maamulka dooran kartaa oo kaliya dhakhtarka daaweynta. Si lama filaan ah u joojiyaan daaweynta Ma wanaagsana, jaaniska sare ee soo noqoshada. Dhameystirka daaweynta dhacdaa by si tartiib tartiib ah yaraynta qiyaasta.

Sababo isticmaalka "Kortefa"

Waxaa jiro liis ku cudurada iyo xaaladaha u shaqeeyo, marka looma ogola in ay qaataan hoos tixgelin waa daawada. Tani dulinka iyo faafa cudurada asal ahaan viral, fangas ama bakteeriya (wareejiyo ee la soo dhaafay la soo dhaafay, loo qaadan meel la joogo).

Ha ka dhigan, haddii bukaanku laga helo psychosis in marxaladda ba'an, diabetes decompensated ama dadka ku xanuunsado hypothyroidism, tayroodh, hypertension, boog cudurada caloosha ulcer iyo lesions maqaar, boog ulcer ama aad qabto nooca faafa.

Waxaa jiro liis ku ah sababo la isku duro intraarticular "Solu-Kortef" daroogada. Ha qoro dawooyinka, iyo in tiro ka mid ah dhibaatooyinka nidaamka wadnaha, oo ay ku jiraan taariikhda dhawaan Wadnaxanuun myocardial.

Waayo, hal cabir, xataa for the "muhiim" contraindication baahna in codsiga waa diidmo shakhsi in qaybaha daroogada.

Waxyeellooyin

From sababo dhowr ah waxay ku xiran tahay inta jeer iyo dhalaalka ka mid ah waxyeelo, liiska taas oo ka kooban daroogada si uu "Kortef" diiwaanka. Tilmaamayaasha, dose, muddada koorsada qoray uu dhakhtarka xaadirka ah waa in la arkay baajin. Qaar ka mid ah muhiimadda ay leedahay ayaa waxaa sidoo kale ku lifaaqan dhaqmayo of laxanka kirkeydiyanka u socoto (isbedbedelka xooga ah hababka kala duwan noolaha la xiriira isbedelka Habeenka iyo Maalinta).

nidaamka hormoonada jidhka ayaa jawaab u helo "Kortefa" waa ay awoodaan in ay ka jawaabaan hoos u dhac ku dareen in sonkorta iyo horumarinta nooca sonkorowga steroid, shaqeeya ee xakamaynta adrenal. Waxaa jirta fursad ah oo soo koraya Cushing ee syndrome, calaamadaha ugu muhiimsan ee ku jira qaab bilaha-qaabeeya ee wajiga, cayilka ah, nooca pituitary ee kordhay heerka cadaadiska dhiigga, daweeyay gravis, xanuunada kala duwan ee caadada ah dumarka.

Reaction of mareenka caloosha iyo mindhicirka noqon kartaa calaamadaha sida lallabo iyo matag, ganaca, iyo ulceration kala duwan steroid ee marinka dheef shiidka, dhiigbaxa, iyo daloolin waxay derbiyada (GI) uu, esophagitis erosive.

Laga soo bilaabo dhinaca dhibaato wadnaha iyo in "Kortef" (user Oo Xaqiijiyay In macluumaadkan) waa arrhythmia, bradycardia, thrombosis, korodhka in tilmaamayaasha cadaadiska dhiigga. Loogana hortegi ee foomka ba'an iyo subacute ah "Kortef" Wadnaxanuun myocardial keeni kartaa faafitaanka galleeyda, Iscelin of formation of unug nabar, taasoo keeni karta in dillaac ah ee muruqa wadnaha.

Guud ahaan si xun u dhaqmayso isticmaalka "Kortefa" qaab ama mid kale waxay noqon kartaa noocyo kala duwan oo xubnaha iyo nidaamyada ee jirka aadanaha. daliilka suurtogalka ah ee nidaamka dhexe ee habdhiska iyo xubnaha dareenka, xanuunada shiid iyo nidaamka muruqyada. Waxay muujin kartaa noocyo kala duwan oo dareen diidmo oo xasaasiyadeed. The macluumaadka ugu dhameystiran jira medicament ah isticmaalka tilmaamaha "Kortef".

Uurka iyo nuujinta

In muddo ah oo uur ah iyo ilmaha naaska si adag uu mamnuucayaa medicament "Kortef" diiwaanka. Description (ay goobjoog ka ahaayeen qaar ka mid ah khamriga benzyl daawada iska hadlaayo), daroogada waxaa ku qoran warar ku saabsan waxyeelada suurtogalka ah isticmaalka "Kortefa" in muddooyinka sida failure hawsha adrenal, gobolka neefsashada, dhimasho.

Carruurta, hooyooyinka inta aad uurka leedahay ayaa lagu qasbay in ay qaataan hydrokortisoni, waa in ka yar kormeer ugu dhow ee shaqaalaha caafimaadka si loo ogaado goor hore ka mid ah Calaamooyinkiisa kaafi adrenal.

Maxay waa in aad lacag bixisid si aad fiiro?

In daaweynta isticmaalka daroogada "Kortef" Codsiga User talinayaa cunto la yareeyo qaadashada cusbo. Intaa waxaa dheer, jidhka waa inuu helaa borotiinka ku filan. Sidoo kale inta lagu jiro xilliga this waa la aqbali karin in la qabto nooc kasta oo tallaalka. loo baahan yahay si korjoogteyn joogto ah argument cadaadiska dhiigga, fiirsashada of glucose ee dhiiga iyo xinjirowga. Waxaa kaloo muhiim ah si ay ula socdaan wax soo saarka kaadida iyo miisaanka bukaanka.

Haddii kasta oo xaalado walaac, dadka lagu Dabcan daweynta leh "Kortefa" waxay u baahan yihiin in la kordhiyo qiyaasta of corticosteroids. Ku saabsan bukaan qaba qaaxada, ku jira marxaladda firfircoon waa in ay qaataan "Kortef" oo kaliya in barbar therapy u dhigma faray in daaweynta cudurka sababaya. In qaaxada dhaca qaab qarsoon, ama habka of gacnta qaaxada imtixaamaa shaqaalaha caafimaadka waa in si dhow ula socdaan xaaladda bukaanka iyo qori chemoprophylaxis ku habboon haddii loo baahdo.

Haddii ballanta daroogada kiciyay horumarinta kaafi adrenal sare, waxaa suurtagal ah in caadi xaaladda by tartiib daawada loo yareeyo. Ka dib markii therapy la dhamaystiro, tan iyo muddo dhowr bilood ah waxaa lagu arki karaa noocan oo kale ah failure. xaaladaha kadeedka badan in ay ka dhaceen muddo this waa calaamad muujinaysa siiwado ee GCS Ahaado.

Sida ee caabuqa herpes fudud ee isha, "ayuu Kortef" (user, codsiga, khubarada dhabta ah waxaa loo tixgeliyaa in maqaalka), iyo wax kasta oo corticosteroids kale waa in la isticmaalaa si taxadir leh u weyn, tan iyo markii ay suurto gal tahay horumarinta daloolin corneal.

Shaqaalaha caafimaadka waa in ay ogaadaan xaqiiqda ah in inta lagu guda jiro daawaynta "Kortefom" qaar ka mid ah cudurada faafa waxay noqon kartaa astaamo, qaab qarsoon, oo waxay leeyihiin heerar kala duwan ee darnaanta. Iyada oo sii kordhaya qiyaasood oo corticosteroids isticmaalo waxay kordhisaa suurtagalnimada of horumarinta cudurada qarsoon. E. Under saameynta ay "Kortefa" iska caabin snizhet infekshinka, dhimaayo awoodda in localize halka uu cudurka.

Kuwa lagu qoray qaadasho jirka "Kortefa" ama wax corticosteroids kale aan lagu talinayaa in aad taabato dadka qaba busbuska ama jadeecada. Haddii xiriiro sida ma dhacaan, waxaad u baahan tahay in si degdeg ah la xiriir dhakhtarka daaweynta.

SCSO noqon kartaa sababta oo ah xanuunada maskaxda, ama in la xoojiyo daliilka waallida jira, kor u xasilooni dareen.

Waxaa jira warar sheegaya in in qaar ka mid ah bukaannada ku saabsan asalka ah "Kortefa" (ama corticosteroids kale) horumariyo Kaposi ee. Si kastaba ha ahaatee, ka dib markii la joojiyo of medicament arkay dembidhaafka kiliinikada.

Waayo, sababta in dhibaatooyin ka dib markii qaadashada daroogada waa si toos ah ay ku xidhan tahay heerka duration iyo qiyaasta, go'aanka inuu ku soo bilowdo koorsada daaweynta, muddada iyo qaadashada ogolyahay dhakhtar qaadataa marka la qiimeynayo faa'iidooyinka lagu eedeeyay uu bukaanka iyo khataraha ka iman kara ee daroogada.

Dhexgalka daroogooyinka kale

Sidaas daraaddeed, waxaan ka wada hadalnay waxa ka dhigan "Kortef". Tilmaamaha loogu isticmaalo, tilmaamo iyo sababo iyo waxyeelo daroogada waxaa sidoo kale loo arkaa. Waxaa weli in la ogaado in kuwa xirfad leh ee magacaabidda daroogada ee bukaanka waa inay ogaadaan in hydrokortisoni waxaa ka jawaabay noocyo kala duwan oo walxaha, iyo xeryahooda waxay keeni kartaa dhaawac halis ah jirka.

Waa midda koowaade, pharmaceutically hydrokortisoni leheyn daawooyin kale oo la isku dayay in la xidhiidha laga yaabaa in ay u sameeyaan insolubles ah. Labaad, waxay kordhisaa sumoobo ee glycosides wadnaha, iyadoo ay sabab u horumariyaan laga yaabaa in hypokalemia, ka dibna waxaa jira halis ah oo u siyaadiyaa arrhythmia.

Iyada oo ka qaybgalka tooska ah "Kortefa" (gaar ahaan, ay qayb weyn ee) kordhiyaa heerka of Digo of acetylsalicylic acid (ASA) iyo heerka content ay hoos dhiigga.

Isticmaalka hydrokortisoni ku saabsan asalka ah ee tallaalka fayruska nool keeni karaan hawshooda u ah ee fayrasyada iyo horumarinta cudurada.

Paracetamol tusmo "Kortefom" waxaa laga yaabaa in hepatotoxic. At maamulka muddo dheer kordhiyaa-fiirsashada ee folic acid ee jirka. At qaadashada sare hydrokortisoni yaraynaysaa oolnimada somatropin (hormone koritaanka).

Intaa waxaa dheer, qayb weyn ee firfircoon oo yaraynaysa waxtarka daawada hypoglycemic laakiin waxay kordhisaa saamaynta daawada xinjirowga lidka ku ah taagayo coumarin. "Kortef" cabudhibayo saamaynta vitamin D ku saabsan habka nuugista ee Ca ₂ + ee Lumen xiidmaha. Under saameynta ay hydrokortisoni kordhiyaa sumoobo ee Cyclosporine iyo ketokonazol.

In joogitaanka walxaha sida ephedrine, theophylline, rifampicin, barbiturates wax saameyn ah ku daweyn of hoos saamayn GCS. Finanka iyo horumarinta hirsutism (koritaanka xad-dhaafka ah terminal - adag oo mugdi ah - timaha in dumarka hannaankii lab) horreeyaa soo dhaweynta oo ay la socdaan daawooyin kale hydrokortisoni steroid hormoon (steroids dhiska, estrogens, piller).

opinion ee macaamiisha ku saabsan daroogada "Kortef"

"Kortef" daroogada aad u adag in ay leeyihiin ma-celin xun. Inkastoo marar badan wanaagsan more. daawooyinka Description "Kortef" (dib u eegista ah ee shaqaalaha caafimaadka xaqiijin xaqiiqda) wuxuu kuu ogolaanayaa inaad si ay u fahmaan sida ay baaxadda ballaadhan, si liiska waa dhacdooyinka dheer oo loo kasin. Siidi by the dib u eegista waxay isu bukaan, qof uu si dhaqso ah laga xoreeyey dhibaatada, taasoo keentay in tayada nolosha, laakiin qof ayaa sababay badan oo dareenkaa u xun, iyo dareenka dadka bukaanka ah ma lahayn wax saameyn ah.

daroogada Tani waa xumaan iyo samaan toona - su'aal aad ciriiri ugu yahay qalab sida "Kortef". Waxa ugu weyn ee halkan - in ay ku tiirsan yihiin waayo-aragnimo iyo khibrad ah dhakhtarka xaadirka iyo hoggaansamaan talooyinka oo dhan.